Provider Demographics
NPI:1245507961
Name:RACHEL ELLIS MD PLLC
Entity type:Organization
Organization Name:RACHEL ELLIS MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:FREMDER
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-822-7546
Mailing Address - Street 1:358 S OYSTER BAY RD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3508
Mailing Address - Country:US
Mailing Address - Phone:516-822-7546
Mailing Address - Fax:516-937-7546
Practice Address - Street 1:358 S OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3508
Practice Address - Country:US
Practice Address - Phone:516-822-7546
Practice Address - Fax:516-937-7546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty